This may be called "eligible expense," "payment allowance" or "negotiated rate." If your provider charges more than the allowed amount, you may have to pay the difference.
Allowed amount Maximum amount on which payment is based for covered health care services. "Allowable" charges are sometimes known as reasonable and customary (R&C) charges. Please note that Mayo Clinic doesn't accept predetermined usual, customary and reasonable (UCR) health insurance payment amounts for health plans with which Mayo Clinic doesn't participate. Allowable This refers to the predetermined allowable limits used by insurance carriers to limit the maximum amount they will pay for a service based on their contract with you. ABNs only apply if you have Original Medicare, not if you are enrolled in a Medicare Advantage private health plan. Also known as a waiver of liability, the ABN (the complete name is "Advance Beneficiary Notice") is a provided when providers offer a service or item they believe Medicare will not cover. Advance Beneficiary Notice (ABN) This is a written notice given to you by a doctor, provider or supplier in advance of any service that Medicare may not consider covered. This person can coordinate the billing, payment, and insurance coverage for the account. Addressee This is the person designated to receive the monthly billing statements. This number is used to track services and payments. Glossary of billing and insurance terms Account Number This is a number assigned to identify each episode of care.
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